Possible Synergy between Recombinant Factor VIIa and Prothrombin Complex Concentrate in Hemophilia Therapy

Nigel S. Key; Beverly Christie; Nicole Henderson; Gary L. Nelsestuen

doi:10.1055/s-0037-1613155

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2002; 88(01): 60-65
DOI: 10.1055/s-0037-1613155

Review Article

Schattauer GmbH

Possible Synergy between Recombinant Factor VIIa and Prothrombin Complex Concentrate in Hemophilia Therapy

Nigel S. Key

¹Department of Medicine, University of Minnesota, Minneapolis, MN

²Hemophilia and Thrombosis Center, Fairview-University Medical Center, Minneapolis, MN

,

Beverly Christie

²Hemophilia and Thrombosis Center, Fairview-University Medical Center, Minneapolis, MN

,

Nicole Henderson

³Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, St. Paul, MN, USA

,

Gary L. Nelsestuen

³Department of Biochemistry, Molecular Biology and Biophysics, University of Minnesota, St. Paul, MN, USA

› Author Affiliations

Abstract

Summary

Recombinant factor VIIa (rFVIIa; Novoseven™) is used for treatment of hemophilia patients with inhibitors. There are poorly defined differences in clinical responsiveness between individuals. Prior to licensure in the United States, rFVIIa was available through the compassionate use program, during which two patients described in this study demonstrated an excellent response. More recently, one of these individuals showed a sub-optimal response to rFVIIa. One possible explanation for different treatment outcomes was sequential therapy with prothrombin complex concentrates (PCC) followed by rFVIIa in the compassionate use program. In support of this, an in vitro test showed that this patient had an exceptionally strong response to rFVIIa when it was added to whole blood after the patient received PCC therapy. Results with other patients supported this hypothesis. With further evaluation, a therapeutic approach combining sequential PCC and rFVIIa may prove useful for treatment of bleeding refractory to either agent used alone.

Keywords

Factor VIIa - prothrombin complex concentrates - haemophilia

Full Text

References

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